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New Prescription to Cure Drinking Problems

Like many people who struggle to control their drinking, Andy Mathisen tried a lot of ways to cut back.

He attended Alcoholics Anonymous meetings, went to a rehab center for alcohol abuse and tried using willpower to stop himself from binge drinking. But nothing seemed to work. This past year, with the stress of the pandemic weighing on him, he found himself craving beer every morning, drinking in his car and polishing off two liters of Scotch a week.

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Frustrated, and feeling that his health and future were in a downward spiral, Mr. Mathisen turned to the internet and discovered Ria Health, a telehealth program that uses online coaching and medication to help people rein in their drinking without necessarily giving up alcohol entirely.

After signing up for the service in March, he received coaching and was given a prescription for naltrexone, a medication that diminishes cravings and blunts the buzz from alcohol. The program accepts some insurance and charges $350 a month for a one-year commitment for people who pay out of pocket. Since he started using it, Mr. Mathisen has reduced his drinking substantially, limiting himself to just one or two drinks a couple of days a week.

“My alcohol consumption has dropped tremendously,” said Mr. Mathisen, 70, a retired telecommunications manager who lives in central New Jersey. “It’s no longer controlling my life.”

Mr. Mathisen is one of the roughly 17 million Americans who grapple with alcoholism, the colloquial term for alcohol use disorder, a problem that was exacerbated this past year as the pandemic pushed many anxious and isolated people to drink to excess. The National Institutes of Health defines the disorder as “a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences.” Yet despite how prevalent it is, most people who have the disorder do not receive treatment for it, even when they disclose their drinking problem to their primary care doctor or another health care professional.

Last month, a nationwide study by researchers at the Washington University School of Medicine in St. Louis found that about 80 percent of people who met the criteria for alcohol use disorder had visited a doctor, hospital or medical clinic for a variety of reasons in the previous year. Roughly 70 percent of those people were asked about their alcohol intake. Yet just one in 10 were encouraged to cut back on their drinking by a health professional, and only 6 percent received any form of treatment.

Alcohol abuse can be driven by a complex array of factors, including stress, depression and anxiety, as well as a person’s genetics, family history and socioeconomic circumstances. Many people kick their heavy drinking habit on their own or through self-help programs like Alcoholics Anonymous or SMART Recovery. But relapse rates are notoriously high. Research suggests that among all the people with alcohol use disorder who try to quit drinking every year, just 25 percent are able to successfully reduce their alcohol intake long-term.

While there is no silver bullet for alcohol use disorder, several medications have been approved to treat it, including pills like acamprosate and disulfiram, as well as oral and injectable forms of naltrexone. These medications can blunt cravings and reduce the urge to drink, making it easier for people to quit or cut back when combined with behavioral interventions like therapy.

Yet despite their effectiveness, physicians rarely prescribe the drugs, even for people who are most likely to benefit from them, in part because many doctors are not trained to deal with addiction or educated on the medications approved to treat it. In a study published last month, scientists at the N.I.H. found that just 1.6 percent of the millions of Americans with alcohol use disorder had been prescribed a medication to help them control their drinking. “These are potentially life saving medications, and what we found is that even among people with a diagnosable alcohol use disorder the rate at which they are used is extremely low,” said Dr. Wilson Compton, an author of the study and deputy director of the National Institute on Drug Abuse.

The implications of this are substantial. Alcohol is one of the most common forms of substance abuse and a leading cause of preventable deaths and disease, killing almost 100,000 Americans annually and contributing to millions of cancers, car accidents, heart attacks and other ailments. It is also a significant cause of workplace accidents and lost work productivity, as well as a driver of frayed family and personal relationships. Yet for a variety of reasons, people who need treatment rarely get it from their physicians.

Some doctors buy into a stereotype that people who struggle with alcohol are difficult patients with an intractable condition. Many patients who sign up for services like Ria Health do so after having been turned away by doctors, said Dr. John Mendelson, a professor of clinical medicine at the University of California, San Francisco, and Ria Health’s chief medical officer. “We have patients who come to us because they’ve been fired by their doctors,” he added.

In other cases, doctors without a background in addiction may worry that they don’t have the expertise to treat alcoholism. Or they may feel uncomfortable prescribing medications for it, even though doing so does not require special training, said Dr. Carrie Mintz, an assistant professor of psychiatry at Washington University and a co-author of the study last month that looked at nationwide treatment rates.

The result is that a lot of patients end up getting referred to mental health experts or sent to rehab centers and 12-step programs like A.A.

“There’s a stigma associated with substance use disorders, and the treatment for them has historically been outside of the health care system,” Dr. Mintz said. “We think these extra steps of having to refer people out for treatment is a hindrance. We argue that treatment should take place right there at point of care when people are in the hospital or clinic.”

But another reason for the low rates of treatment is that problem drinkers are often in denial, said Dr. Compton at the National Institute on Drug Abuse. Studies show that most people who meet the criteria for alcohol use disorder do not feel that they need treatment for it, even when they acknowledge having all the hallmarks of the condition, like trying to cut back on alcohol to no avail, experiencing strong cravings, and continuing to drink despite it causing health and relationship problems.

“People are perfectly willing to tell you about their symptoms and the difficulties they face,” Dr. Compton said. “But then if you say, ‘Do you think you need treatment?’ they will say they do not. There’s a blind spot when it comes to putting those pieces together.”

Studies suggest that a major barrier to people seeking treatment is that they believe that abstinence is their only option. That perception is driven by the ubiquity and long history of 12-step programs like A.A. that preach abstinence as the only solution to alcoholism. For some people with severe drinking problems, that may be necessary. But studies show that people who have milder forms of alcohol use disorder can improve their mental health and quality of life, as well as their blood pressure, liver health and other aspects of their physical health, by lowering their alcohol intake without quitting alcohol entirely. Yet the idea that the only option is to quit cold turkey can prevent people from seeking treatment.

“People believe that abstinence is the only way — and in fact it’s not the only way,” said Katie Witkiewitz, the director of the Addictive Behaviors and Quantitative Research Lab at the University of New Mexico and a former president of the Society of Addiction Psychology. “We find robust improvements in health and functioning when people reduce their drinking, even if they’re not reducing to abstinence.”

For people who are concerned about their alcohol intake, Dr. Witkiewitz recommends tracking exactly how much you drink and then setting goals according to how much you want to lower your intake. If you typically consume 21 drinks a week, for example, then cutting out just five to 10 drinks — on your own or with the help of a therapist or medication — can make a big difference, Dr. Witkiewitz said. “Even that level of reduction is going to be associated with improvements in cardiovascular functioning, blood pressure, liver function, sleep quality and mental health generally,” she added.

Here are some tools that can help.

— Ria Health is a telehealth program that offers treatment for people with alcohol use disorder. It provides medical consultations, online coaching, medication and other tools to help people lower their alcohol intake or abstain if they prefer. It costs $350 a month for the annual program, cheaper than most rehab programs, and accepts some forms of health insurance.

— The National Institute on Alcohol Abuse and Alcoholism has a free website called Rethinking Drinking that can help you find doctors, therapists, support groups and other ways to get treatment for a drinking problem.

— Cutback Coach is a popular app that helps people track their alcohol intake and set goals and reminders so they can develop healthier drinking habits. The service allows people to track their progress and sends out daily reminders for motivation. The cost is $79 if you pay annually, $23 per quarter or $9 a month.

— Moderation Management is an online forum for people who want to reduce their drinking but not necessarily abstain. The group offers meetings, both online and in person, where members can share stories, advice and coping strategies. It also maintains an international directory of “moderation-friendly” therapists.

— CheckUp & Choices is a web-based program that screens people for alcohol use disorder. It provides feedback on your drinking habits and options for cutting back. The service charges $79 for three months or $149 per year.

© 2021 The New York Times Company

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Pop mogul Simon Cowell was a racing flop with ‘awful’ £35,000 horse he owned with Ant and Dec – that didn’t win a penny

SIMON COWELL conquered the music world – but his foray into racing ended in disaster with an ‘awful’ £35,000 horse he owned with Ant and Dec.

The music mogul, 62, has done it all with bands like One Direction, Little Mix and solo acts Olly Murs and James Arthur, to name but a few.

Cowell owned an 'awful' £35,000 horse with Ant and Dec - but the runner didn't win a single penny in six races

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Cowell owned an ‘awful’ £35,000 horse with Ant and Dec – but the runner didn’t win a single penny in six racesCredit: PA:Press Association
Cowell remains a massive racing fan and loves Royal Ascot and the Epsom Derby

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Cowell remains a massive racing fan and loves Royal Ascot and the Epsom Derby

His Syco label – plus shows such as Britain’s Got Talent – have dominated the entertainment industry and brought him an estimated net worth of £385m.

A lover of Royal Ascot and the Epsom Derby, he looked perfectly poised to strike a knockout blow in the world of thoroughbreds.

But it turns out his runner was far from No1 in the charts – and never even finished better than fifth during a doomed six-race career.

Things looked promising at the start.

Named It’s A Yes From Me, the runner was trained with the respected James Fanshawe and sent off at 8-1 for his first race in June 2014.

But coming last of five by 13-and-a-half lengths was unfortunately about as good as it got for the gelding.

A month’s rest followed before he was sent off at 40-1 in a six-furlong sprint at Doncaster.

But there he could only manage fifth again, and it was same at Redcar the next month.

‘Dreadfully slow’

By October that year – with further finishes of sixth and tenth – It’s A Yes From Me came second-last in a one-mile race at Kempton.

One analysis of the race warned punters the horse was ‘one to tread carefully’ with.

Well, Cowell and Ant and Dec took that advice to heart as they never raced him again.

The horse was penniless from six races, never finishing high enough to recoup some of that £35,000 investment.

It’s doubtful Cowell, with hundreds of millions in the bank, lost any sleep over that.

But Ant and Dec revealed just how bad things has got with the horse during an interview last year.

Dec said of It’s A Yes From Me: “It was awful, it was a dreadfully slow horse.

“It wasn’t a racehorse it was just a horse, because it didn’t race.

“Every time we got to the BGT studio Simon would say, ‘I keep paying stable fees on this horse, but I’ve never seen it run’.”

Cowell originally wanted to name the nag after himself, but they settled on It’s A Yes From Me when they bought it in 2013.

‘It was awful’

Dec revealed its eventual fate: “I think it got rehomed.”

Of course it’s not all been bad for Cowell at the races.

He was one of the exclusive few at the Epsom Derby in June, having a great time with partner Lauren Silverman and Piers Morgan.

And two weeks later he was at Royal Ascot – where he first discovered his love of racing.

Cowell told SunSport’s Matt Chapman during a chat at Epsom: “I’ve got my son Eric with me today.

“My mum and dad years ago used to take me to Ascot and I was probably about his age – seven or eight.

Cowell with partner Lauren at Epsom earlier this year

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Cowell with partner Lauren at Epsom earlier this yearCredit: Getty
It's A Yes From Me trails behind in last during one of his six races

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It’s A Yes From Me trails behind in last during one of his six races
The music supremo tweeted about his horse's bad start... which never got much better

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The music supremo tweeted about his horse’s bad start… which never got much better

Most read in Horse Racing

“So the fact I can now bring him to the races as well is brilliant. It brings back a lot of good memories.

“Making TV shows is my passion. But racing is actually my second passion.”

He hasn’t made that passion the money-maker his music label is, but don’t rule out Cowell staging his own comeback at the track in the near future.

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Commercial content notice: Taking one of the bookmaker offers featured in this article may result in a payment to The Sun. 18+. T&Cs apply. Begambleaware.org


Remember to gamble responsibly

A responsible gambler is someone who:

  • Establishes time and monetary limits before playing
  • Only gambles with money they can afford to lose
  • Never chases their losses
  • Doesn’t gamble if they’re upset, angry or depressed
  • Gamcare – www.gamcare.org.uk
  • Gamble Aware – www.begambleaware.org

Commercial content notice: Taking one of the bookmaker offers featured in this article may result in a payment to The Sun. 18+. T&Cs apply. Begambleaware.org


Remember to gamble responsibly

A responsible gambler is someone who:

  • Establishes time and monetary limits before playing
  • Only gambles with money they can afford to lose
  • Never chases their losses
  • Doesn’t gamble if they’re upset, angry or depressed
  • Gamcare – www.gamcare.org.uk
  • Gamble Aware – www.begambleaware.org
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Minnesota wildfire doubles in size, creates its own weather

A wildfire in northeastern Minnesota more than doubled in size Tuesday, growing to more than 19,000 acres, after it produced pyrocumulous clouds that generated lightning and even raindrops, fire officials said.

The Greenwood Fire’s growth, most of which happened Monday afternoon, prompted firefighters to leave McDougal Lake, about 80 miles south-southwest of Duluth, officials said. Authorities fear that structures might have been destroyed or damaged.

“We had crews embedded, and as this fire took off, it was quite an effort to communicate with forces on the ground so they could get out,” said federal fire incident spokesman Clark McCreedy.

The pullout was a success, and no injuries were reported. However, downed trees and necessary cleanup mean crews have been unable to assess damage around the lake, McCreedy said.

In addition to the firefighter pullout, 159 dwellings were evacuated Monday, according to an update from the National Wildfire Coordinating Group. Cabins, homes and recreational sites remain under threat, the group said.

Patrick Prochaska, a Minneapolis resident who built a cabin near McDougal Lake in 2012, told NBC affiliate KARE that he watched via security camera as flames mostly bypassed his property Monday, causing minor damage.

“I was feeling very scared,” he said. “At the same time, I could see that it was not doing anything to the house, and it was kind of reassuring.”

The fire in and north of Superior National Forest has mostly performed according to the weather, fire officials said. On Monday, with dry fuel on the ground and temperatures in the high 80s, it was an expanding inferno punctuated by strobes of lightning.

“The winds were drawn into the fire from all directions,” the incident’s fire behavior analyst, Michael Locke, said in a video update Tuesday. “It created what we call pyrocumulous clouds. And really high in the atmosphere … you’d see a thunderstorm, and in fact they went high enough to produce a few sprinkles of rain and even some lightning.”

Temperatures dipped into the mid-70s Tuesday, and the blaze mellowed. “The real story was cloud cover and cooler temperatures,” McCreedy said.

More of the same, and possibly rain, was in the forecast, giving officials hope that they might be able to close the book on an unusually active and dry fire season in Minnesota.

Experts have said climate change has set the stage for extreme weather, including an increase in the frequency and intensity of wildfires in the Northern Hemisphere.

Firefighters — 426 were assigned to the Greenwood event — have been confronted with “prolonged, severe drought,” making parts of Minnesota look like the fire-prone West this summer, McCreedy said.

The Greenwood Fire, which was detected Aug. 15, is believed to have been sparked by lightning.

So far, firefighters have scored no containment, and areas including McDougal Lake, Sand Lake and the Highway 2 corridor have been under mandatory evacuation orders. The federal Boundary Waters Canoe Area Wilderness was closed Saturday “due to active and increasing fire activity, extreme drought, limited resources,” the National Forest Service said in a notice.

Officials set a goal of Sept. 1 for full containment.

“We’re probably going to get more of that moderating weather for the rest of the week,” McCreedy said. “That opens the door for fire crews to make progress on the ground.”

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Hiker survives grizzly bear attack at Denali National Park

A tourist from Indiana was attacked and injured by a grizzly bear at Denali National Park and Preserve in Alaska on Monday night, park officials said.

The 55-year-old tourist, whose name was not released, was hiking alone in dense fog in the Thoroughfare Pass area when a mother bear and multiple cubs charged him from nearby bushes, the National Park Service said in a statement Tuesday.

He had puncture wounds to a calf, his left ribs and his left shoulder, the agency said.

The victim used bear spray that might have cut the attack short, the park service indicated. He walked 1.5 miles to a visitor’s center where “medical personnel” vacationing at Denali treated him as a park bus driver called 911, it said.

The hiker was taken to a medical center near the park before he was transferred to Fairbanks Memorial Hospital, about 120 miles away, park officials said. He was stabilized at the Fairbanks hospital, they said.

“Due to the apparent defensive nature of this attack, there are no plans to locate the bear involved,” the park service said. “Female bears with cubs are naturally defensive of their young, especially when surprised. There is no indication that this bear is unusually dangerous.”

Grizzly bears are federally protected as a threatened species in the lower 48 states. According to the National Wildlife Federation, fewer than 1,500 grizzlies are left in the lower 48, but they thrive, comparatively, in Alaska, where they have a population of about 31,000.

The backcountry area of the attack is closed for one week as a precaution, the park service said.

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